PDF icon Download PDF
Semin intervent Radiol 2022; 39(02): 194-202
DOI: 10.1055/s-0042-1745800
How I Do It

Emborrhoid: Rectal Artery Embolization for Hemorrhoid Disease

Julien Panneau
1   Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, Marseille, France
2   Aix Marseille University, LIIE, Marseille, France
3   Aix Marseille University, CERIMED, Marseille, France
,
Diane Mege
4   Department of Visceral Surgery, Aix-Marseille University, Hôpital de la Timone, Marseille, France
,
Mathieu Di Biseglie
1   Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, Marseille, France
2   Aix Marseille University, LIIE, Marseille, France
3   Aix Marseille University, CERIMED, Marseille, France
,
Julie Duclos
4   Department of Visceral Surgery, Aix-Marseille University, Hôpital de la Timone, Marseille, France
,
Paul Habert
1   Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, Marseille, France
2   Aix Marseille University, LIIE, Marseille, France
3   Aix Marseille University, CERIMED, Marseille, France
,
Vincent Vidal
1   Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, Marseille, France
2   Aix Marseille University, LIIE, Marseille, France
3   Aix Marseille University, CERIMED, Marseille, France
,
Farouk Tradi
1   Interventional Radiology Section, Department of Medical Imaging, University Hospital Timone, AP-HM, Marseille, France
2   Aix Marseille University, LIIE, Marseille, France
3   Aix Marseille University, CERIMED, Marseille, France
› Author Affiliations
› Further Information
Also available ateRefMedOne
   Permissions and Reprints
Preview

Hemorrhoids are a common anorectal disease, defined as the enlargement and symptomatic prolapse of the hemorrhoidal cushions. It affects millions of people around the world and is a major medical and socioeconomic problem.

In recent years, an improved anatomical understanding and the need to develop minimally invasive approaches have led to the development of the Doppler-guided hemorrhoidal artery ligation (DG-HAL) procedure as an effective treatment for hemorrhoids.[1]

The DG-HAL procedure uses dedicated equipment and involves the identification of hemorrhoidal arteries using Doppler ultrasound, and their ligation to decrease the flow of arterial blood to the hemorrhoidal cushions. This procedure is performed via the transanal route under local anesthesia.

This technique has several advantages: it leaves the hemorrhoidal tissue in place, preserves anal continence, and is significantly less painful and less prone to complications than open surgery, allowing patients to return to work sooner.[2]

Based on the underlying principles of this technique, we have developed the “emborrhoid” embolization technique, in which endovascular occlusion of the arteries from the distal branches of the inferior mesenteric artery (IMA) is performed. Our preliminary results for this technique have been reported in other publications.[3] [4] [5] [6] [7] [8] [9] [10]

Compared with DG-HAL, the endovascular approach offers the advantage of identifying all the hemorrhoidal arterial branches, recognizing anatomical variations, and ensuring effective occlusion of the target branches, which could improve therapeutic results. No comparative study between the two techniques has yet been performed.

The aim of this article is to describe our team's current methods and results for the emborrhoid technique as the main alternative treatment for patients with hemorrhoids.



Publication History

Article published online:
30 June 2022

© 2022. Thieme. All rights reserved.

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA